Epidemiology of syndactyly in New York State

BACKGROUND: There is paucity of literature focusing on the incidence and surgical management of syndactyly. In this study, we describe the incidence and rates of surgical management of patients with syndactyly in New York State. AIM: To describe the incidence and surgical management of patients with syndactyly using an America's population-based database. METHODS: We conducted a retrospective study using the New York State Statewide Planning and Research Cooperative System. All patients with a diagnosis of syndactyly at birth were identified and followed longitudinally to determine yearly incidence as well as demographic and surgical factors. Descriptive statistics and univariate analyses were used. RESULTS: There were 3306 newborns with a syndactyly diagnosis between 1997 and 2014 in New York State. The overall incidence was 0.074% or 7 cases per 10000 live births. A small number of patients underwent surgical correction in New York State (178 patients, 5.4%). Among the surgical patients, most of the operations were performed before the age of two (79%). Approximately 87% of surgeries were performed at teaching hospitals, and 52% of procedures were performed by plastic surgeons. Skin grafting was performed in 15% of cases. Patients having surgery in New York State were more likely to have Medicaid insurance compared to patients not having surgery (P = 0.02). CONCLUSION: Syndactyly occurs in approximately 7 per 10000 live births, and the majority of patients undergo surgical correction before age two. There may be several barriers to care including the availability of specialized hand surgeons, access to teaching hospitals, and insurance status.